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Partnership. Policy. Action. STRONGER HEARTS™ PARTNERSHIP: IMPROVING THE LIVES OF PATIENTS WITH HEART FAILURE 12th Annual Meeting - National Forum for.

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Presentation on theme: "Partnership. Policy. Action. STRONGER HEARTS™ PARTNERSHIP: IMPROVING THE LIVES OF PATIENTS WITH HEART FAILURE 12th Annual Meeting - National Forum for."— Presentation transcript:

1 Partnership. Policy. Action. STRONGER HEARTS™ PARTNERSHIP: IMPROVING THE LIVES OF PATIENTS WITH HEART FAILURE 12th Annual Meeting - National Forum for Heart Disease and Stroke Prevention Barbara Jordan Conference Center, Kaiser Family Foundation Washington, D.C. October 22,2014 Keith C. Ferdinand, MD FACC,FAHA,FASH,FNLA Professor of Clinical Medicine Tulane University School of Medicine Chair, National Forum 1

2 Partnership. Policy. Action. Definition of Heart Failure A complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood 1 Cardinal manifestations of HF are dyspnea and fatigue, which may limit exercise tolerance and fluid retention, which may lead to pulmonary congestion and peripheral edema 1 1. Hunt SA et al. Circulation. 2005;112:e154-e235. 2. Jessup M et al. N Engl J Med. 2003;348:2007-2018. Normal heart 2 Hypertrophied heart (diastolic HF) 2 Dilated heart (systolic HF) 2 2

3 Partnership. Policy. Action. Alignment with The Public Health Action Plan to Prevent Heart Disease and Stroke: Ten-Year Update The 2014 Action Plan identified a need for action in the area of heart failure (HF):  High prevalence and mortality  Deaths in 2009 from HF totaled 56,410  5.1 million Americans currently live with the disease  Disparities: Higher prevalence among black males and females  HF prevalence believed to be steadily increasing and estimated to reach over 8 million Americans by 2030  High cost burden  HF total cost burden projected to increase to $70 billion in 2030, a 120% increase from 2012  Projected cost of HF treatment would exceed $160 billion in direct costs when including the total costs of all cardiac care for HF patients 3 Labarthe D, Grover B, Galloway J, Gordon L, Moffatt S, Pearson T, Schoeberl M, Sidney S. The Public Health Action Plan to Prevent Heart Disease and Stroke: Ten-Year Update. Washington, DC: National Forum for Heart Disease and Stroke Prevention; 2014

4 Partnership. Policy. Action. Etiology of Heart Failure Adapted from Yancy CW. J Card Fail. 2003;9:S210-S215. Heart Failure More common cause of HF cases in blacks MI More common cause of HF cases in whites LVH HypertensionCoronary Artery Disease LVH = left ventricular hypertrophy HF = heart failure MI = myocardial infarction 4

5 Partnership. Policy. Action. Blood Pressure Lowering Treatment Trialists’ Collaboration. Lancet. 2000;355:1955-1964. Long-term Antihypertensive Therapy Significantly Reduces CV Events 35%-40% 20%-25% >50% Average reduction in events (%) -60 -50 -40 -30 -20 -10 0 Stroke Myocardial infarction Heart failure n=201,566 5

6 Partnership. Policy. Action. Kotchen TA et al. N Engl J Med. 2013;368:1229-1237. Target-Organ Damage Due to High Intake of Sodium Chloride. 6

7 Partnership. Policy. Action. Projected HF: Race/Ethnicity 2012-2030 Heidenreich PA et al. Circ Heart Fail. 2013;6:606-619. 7

8 Partnership. Policy. Action. Eliminating Disparities Social Determinants of Health The circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness These circumstances in-turn shaped by a wider set of forces: economics, social policies, and politics 8

9 Partnership. Policy. Action. Review of initiative goals The initiative began in Fall 2013 and is supported by an unrestricted sponsorship from Novartis The goals of this 2-3 year initiative are to: – Engage the right collaborators to carry out a set of high probability strategies to improve outcomes for people with heart failure – Measure the outcomes and report on successes to encourage their widespread adoption 9

10 Partnership. Policy. Action. Steering Committee 10 Inder Anand, MD, FACC, FRCP, DPhil VA Medical Syst em Jerry Penso, MD, MBA American Medical Group Association Javed Butler, MD, MPH Emory University Sara Paul, DNP, FNP, FAHA Catawba Valley Cardiology Marjory Cannon, MD Centers for Medicare and Medicaid Services Ileana Piña, MD, MPH Albert Einstein College of Medicine Keith C. Ferdinand, MD, FACC, FAHA, FASH Tulane University School of Medicine Gary Puckrein, PhD National Minority Quality Forum Gregg Fonarow, MD, FACC, FAHA UCLA Division of Cardiology Rhodes Rigsby, MD, MBA Loma Linda University Medical Center Laura Gordon Edelman Joanna Sikkema, DNP, ANP-BC, FAHA University of North Dakota David Kountz, MD, MBA, FACP Jersey Shore Medical Center Frank Smart, MD, FACC, FACP LSU Health Sciences Center Steven Manoukian, MD, FACC, FSCAI Hospital Corporation of America, Inc. Paul Underwood, MD, FACC, FACP Boston Scientific Corporation David Nilasena, MD, MSPH, MS Centers for Medicare & Medicaid Services, Region IV Clyde Yancy, MD, FACC, FAHA, MACP Northwestern University Feinberg School of Medicine

11 Partnership. Policy. Action. Tactic: Stronger Hearts™ Helpline pilot program During Phase 1 of the project, Steering Committee worked to identify a high probability tactic to address the burden of heart failure at a community level: Vision: to provide the model for a scalable community-based tool to help strengthen awareness around heart failure, heighten patients’ sense of empowerment over their disease and enhance their ability to follow the treatment plan that their provider has laid out for them – The Stronger Hearts™ Helpline will draw upon existing resources both nationally and in the community, including the 2-1-1 call center infrastructure Phase 2 of the project will focus on implementation of the helpline, measurement and preparation for publication 11

12 Partnership. Policy. Action. Pilot site: San Bernardino, CA 12 Community snapshot: – Largest county in contiguous US – Highly diverse area: Both rural and urban areas Total population: 2.088 million “Majority minority” population: 49.9% Latino, 7.8% African American – High rates of cardiovascular disease – Rising rates of high blood pressure – Disproportionate rates of hospitalization connected with CV

13 Partnership. Policy. Action. Stronger Hearts™ Helpline pilot program 13

14 Partnership. Policy. Action. History of nationwide 2-1-1 The FCC established 2-1-1 permanently as a national network of health and human service referral lines in 1997 San Bernardino 2-1-1 infrastructure highlights Launched in 2006, fielded over 69,000 calls in 2013 Accredited by Alliance of Information and Referral Systems Experience serving as helpline for the Dept. of Behavioral Health (6+ years) Sophisticated call logging, messaging and recording capabilities Recognized as a trusted community resource, including by Hispanic, African American and the elderly communities which face the highest HF disparities Background on San Bernardino 2-1-1 system 14

15 Partnership. Policy. Action. Launch plans 15 Stronger Hearts™ Helpline launch events targeted for December 2014 National Forum invites members who are interested in joining the publication efforts related to the Stronger Hearts™ Helpline to contact Inside Edge Consulting. Areas needed: Science writers Experienced authors National Forum is actively recruiting San Bernardino area hospitals, health groups, and other important stakeholders to join in participating in the Stronger Hearts™ Helpline ---- please see our Executive Director if you would like to become involved in: Representation of resources in the helpline Participation in awareness building

16 Partnership. Policy. Action. Cholesterol awareness initiative Supported by an unrestricted grant from Sanofi / Regeneron Recruitment of Blue Ribbon Steering Committee to develop strategic framework Dissemination of strategies and interventions Collection, analysis, and report of results Endeavor to connect and prioritize with the Million Hearts™ campaign 16

17 Partnership. Policy. Action. THANK YOU 17

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